紧急经食管心房起搏抢救阿—斯综合征二例

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例1 男,44岁,因慢性肾炎尿毒症,于1936年10月3日入院,行腹膜透析治疗。住院48天,一般情况明显好转。于12月1日夜间,突发胸闷,气急,经用50%葡萄糖加0.4mg西地兰静注后症状不减。心电图示I°AVB,室内阻滞,继之出现室性自搏心律,室率为38次/min。用阿托品1 mg静注无效,心跳呼吸停止心电图呈一直线,意识丧失,瞳孔散大,血压0/0,立即气管插管人工呼吸机给氧,并食管行心脏起搏,电极置于距门齿38 cm处,电压35V,脉宽7ms,固定频率90次/min。开始心电示波仅见有起搏信号,5分钟后可见极宽的紧跟起搏信号后的心室波群,QRS间期0.22s,心室夺获成功。持续起搏至21分钟后恢复为窦性心 Example 1 Male, 44 years old, due to chronic nephritis uremia, was admitted on October 3, 1936, peritoneal dialysis treatment. 48 days hospitalization, the general situation was significantly improved. On the night of December 1, sudden chest tightness, shortness of breath, after 50% glucose plus 0.4mg cedilanid intravenous injection symptoms diminished. ECG I ° AVB, intracranial block, followed by the emergence of ventricular stroke, ventricular rate was 38 beats / min. Atropine 1 mg intravenous injection, heartbeat stopped breathing electrocardiogram was a straight line, loss of consciousness, mydriasis, blood pressure 0/0, immediately tracheal intubation artificial ventilator oxygen and esophageal cardiac pacing, the electrode placed in the incisors 38 cm, voltage 35V, pulse width 7ms, fixed frequency 90 times / min. Only began to see ECG pacing signals, 5 minutes after the pacing signal can be seen very wide after the ventricular wave group, QRS interval 0.22s, successful ventricular seizure. Continuous pacing to 21 minutes after the return to sinus heart
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